Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.
Int J Eat Disord. 2020 Jul;53(7):1056-1079. doi: 10.1002/eat.23259. Epub 2020 Mar 17.
Anorexia nervosa (AN) is associated with neuropsychological characteristics such as impairments in central coherence, cognitive flexibility, and emotion recognition. The same features also manifest in autism spectrum disorders (ASD) and have been suggested to be associated with illness prolongation in AN. The purpose of this meta-analysis was to examine whether pronounced neuropsychological characteristics related to ASD are associated with illness duration in AN.
Four databases (Medline, PsycINFO, Scopus, PubMed) were searched for eligible studies. Search terms were (a) "anorexia nervosa" and (b) "cognitive flexibility" or "set-shifting" or "central coherence" or "emotion recognition" or "theory of mind". The final sample consisted of 53 studies. Duration of AN was divided into three categories in order to investigate differences between the groups with varying illness duration. The meta-analysis was performed with Review Manager using a random-effects model.
Deficits in central coherence, cognitive flexibility, and emotion recognition were pronounced among individuals with prolonged AN compared to those with shorter illness duration.
A prolonged course of AN appears to be associated with underlying neuropsychological characteristics that are also distinctive to ASD. Neuropsychological impairments may lead to prolonged AN, and prolonged illness may contribute to the subsequent "neurological scar effect," further strengthening these impairments.
神经性厌食症（AN）与神经心理学特征有关，例如中央连贯、认知灵活性和情绪识别方面的损伤。这些特征也存在于自闭症谱系障碍（ASD）中，并被认为与 AN 的病程延长有关。本研究的目的是探讨与 ASD 相关的明显神经心理学特征是否与 AN 的病程有关。
在 Medline、PsycINFO、Scopus 和 PubMed 四个数据库中搜索符合条件的研究。搜索词为（a）“神经性厌食症”和（b）“认知灵活性”或“转换灵活性”或“中央连贯”或“情绪识别”或“心智理论”。最终样本包括 53 项研究。为了研究不同病程组之间的差异，将 AN 的病程分为三组。使用 Review Manager 进行荟萃分析，采用随机效应模型。
与病程较短的个体相比，病程较长的 AN 个体的中央连贯、认知灵活性和情绪识别缺陷更为明显。
AN 的病程延长似乎与 ASD 特有的潜在神经心理学特征有关。神经心理学损伤可能导致 AN 病程延长，而病程延长可能导致随后的“神经瘢痕效应”，进一步强化这些损伤。
